Coxarthrosis (osteoarthritis of the hip joint) is a degenerative-dystrophic disease of the hip joints, accompanied by damage to the articular cartilage, bone tissue and periarticular structures and leading to persistent loss of joint function.
Osteoarthritis of the hip joints is one of the most serious pathologies of money-assisted dystrophy of the musculoskeletal system. The disease quickly leads to a decrease in physical activity, a change in the nature of a person's movements, often - to the impossibility of independent movement and disability. Several decades earlier, coxarthrosis was considered one of the "diseases of old age", but since the beginning of this century there has been a high incidence among young and middle-aged patients, which is associated with various reasons.
Statistics
Osteoarthritis is the most common pathology of the musculoskeletal system and occurs in 70% of adults; coxarthrosis - in 25% of patients with orthopedic profile. Up to 30% of patients diagnosed with coxarthrosis are disabled, have a disability, and require joint replacement surgery.
The disease occurs from 20-25 years, the average age of onset of symptoms is 37-39 years, progresses with age, which is associated with the presence of concomitant pathologies of the musculoskeletal system, bone loss, etc. %, in people over 85 years old - 35%. In children and adolescents, coxarthrosis is a consequence of congenital dysplasia of the joints, which is observed in 1% of newborns.
Reasons for development
The reasons that lead to the development of osteoarthritis of the hip joint have different meanings depending on the age and general health of each patient:
- congenital disorder of the normal anatomical shape of the joints - deformity of the femoral neck, congenital dislocation of the hip;
- deformation of the femoral head due to degenerative (age-related) processes in the joint;
- traumatic injuries - fractures, dislocations, non-physiological, including sports, loads on the joints;
- infectious and inflammatory diseases - tuberculosis, osteomyelitis and others;
- rheumatoid arthritis and other systemic (allergic, metabolic) diseases;
- if the exact cause of the disease has not been established and has developed on its own, the term "idiopathic coxarthrosis" is used.
Symptoms of coxarthrosis of the hip joint
Pain is the main symptom. Their severity and the addition of other manifestations of coxarthrosis depends on many factors, in particular, on body weight, lifestyle, age. At the initial stage, patients notice moderate and intermittent pain in the hip joints, which occurs mainly during physical exertion and passes by itself. Then the pain begins at light loads, does not go away at rest, "shoots" in the knee joint. The mobility of the joint or both joints is limited.
Patients are forced to limit physical activity, lameness, "the gait of the duck" appears. In the final stage, constant excruciating pain is observed, the mobility of the hip joints is sharply limited, walking is only possible with a cane or crutches, patients need 24-hour assistance, they are disabled.
Development
As the disease progresses, the hip joint gradually collapses and completely loses its function.
There is a thinning of the joint cartilage and a slight narrowing of the joint space. The bone tissue located under the cartilage becomes denser. At this stage, pain appears after exercise.
In the second stage, the destruction of the cartilage progresses. Marginal osteophytes appear - bone growths. The narrowing of the joint space progresses. Pain occurs when walking, limitation of joint mobility (contracture).
In the final stage of coxarthrosis, the bone growths are extended, flattening and subluxation of the femoral head occurs, the joint space practically disappears. Constant severe pain, joint mobility is significantly limited.
Diagnosis of coxarthrosis
If you experience pain in the groin area, limitation of joint mobility and other symptoms listed above, you can consult a therapist, but the leading medical specialist who diagnoses and treats osteoarthritis of the hip joint is an orthopedic traumatologist.
The main method of diagnosing coxarthrosis is x-ray. This is an informative method that allows you to accurately assess structural changes in the affected joints. Due to its cost-effectiveness and convenience, joint radiography is still widely used. X-ray computed tomography is a more informative (but expensive) method. Magnetic resonance imaging (MRI) of the joints is also used. It is performed to detect coxarthrosis in the pre-radiographic stage (when there are still no changes on X-rays), as well as for differential diagnosis.
Treatment of coxarthrosis of the hip joint
In the early stages of coxarthrosis, with a favorable course of the disease, conservative methods using physiotherapy techniques are preferred, including kinesitherapy, massage and physiotherapy, in particular, water and mud therapy, a physiotherapy complex. Among the physiotherapy techniques that have proved effective, magnetotherapy can also be distinguished.
Magnetic therapy for coxarthrosis is used for various purposes. Under the influence of a magnetic field in the body, regeneration processes are activated, including in bone tissue, blood circulation is improved. This last point is particularly important, since in osteoarthritis there is an insufficient blood supply to the joints, and therefore a lack of nutrients to maintain the normal state of cartilage and bone tissue, and this can aggravate the pathological changes in thearticulation. The improvement of blood circulation in the area of the hip joints helps to restore the flow of necessary nutrients to the joints, activates the metabolism in the bone and cartilage tissue, which is the basis of the positive effect of magnetotherapy in coxarthrosis.
Furthermore, due to the enhancement of metabolic processes and the release of some biologically active substances, the anti-inflammatory and analgesic effect of magnetotherapy is observed.
Diet therapy is recommended to normalize metabolism and reduce body weight. Along with a rational diet, it is possible to use auxiliary preparations (biologically active medicines and pharmaceutical additives) that affect the metabolic and recovery processes of the musculoskeletal system - based on glucosamine and chondroitin (chondroprotectors), minerals and vitamins, standardized plant extracts.
Preparations with anesthetic and anti-inflammatory effect, namely NSAIDs, GCS, muscle relaxants and some others, are used in all stages of coxarthrosis to eliminate pain and inflammation. Their use must be strictly dosed, under the supervision and prescription of a doctor.
In the second or third stage of the disease, depending on the patient's symptoms and condition, it is recommended to continue conservative treatment or surgical intervention. Currently, various surgical methods are used, the best results (complete restoration of joint function and human mobility) are achieved with total arthroplasty - replacement of the hip joint.
Drug therapy, diet therapy and lifestyle changes, physiotherapy and spa treatments are also recommended, both in the case of surgery and in a conservative approach. Physiotherapy techniques in complex treatment can reduce the amount of drugs and the load on the body, promote faster recovery after surgery, improve the general condition of the patient. In particular, magnetotherapy shows good efficacy and tolerance, even in debilitated patients, the elderly and people with chronic diseases of the nervous and cardiovascular systems.
Prevention of osteoarthritis of the hip joint
As a preventive measure, early detection of coxarthrosis is very important. If you find symptoms (pain, limited mobility) in the area of the hip joints, you need to consult a doctor: first you can visit a therapist, then an orthopedic surgeon. The therapist can prescribe an initial treatment to relieve pain, recommend chondroprotectors, and the orthopedist will prescribe special treatment.
The absence of excess weight and normal physical activity, correction of working conditions and lifestyle in general, as well as timely treatment of diseases that can become one of the causes of the development of coxarthrosis (inflammatory, infectious diseases of the joints, congenital anatomical defects of the joints, degenerative dystrophic diseases).